Injury clouds also weigh over Ben Stokes (knee) and Chris Woakes (thigh), meaning England could be left scrambling for another all-rounder.

Throw the form of resurgent James Vince, Sam Curran and the possibility of recalling Moeen Ali into the mix, and England selectors have plenty to think about before the Test starts on Thursday night.

By comparison, India are untroubled and have the momentum after its 203-run win at Trent Bridge last week.

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Injury clouds weigh over Ben Stokes (knee) and Chris Woakes (thigh), meaning England could be left scrambling for another all-rounder.

Bairstow remained hopeful of his inclusion on Tuesday, telling reporters that the swelling in the middle finger of his left hand has gone down.

He added: "I'm going to try and keep wicket in training this afternoon as well."

Even if Bairstow is included purely as a specialist batsman, England, seeking a victory that would see them win the series, will still have to consider whether they need to bolster their fallible top order.

"When you see that a batsman has a weakness and he feels uncomfortable in some way, you'd prefer to work on that aspect," paceman Shami said. "We will definitely look at that."

If Bairstow is ruled out completely, Vince is set for an England recall on his home ground, with one-day wicketkeeper Jos Buttler taking over behind the stumps.

England have been four for 100 or worse in half of its past 62 Test innings, meaning Vince could return even if Bairstow plays.

Vince was dropped by England after a tour of Australia and New Zealand that left him with overall Test figures of 548 runs from 13 matches at 24.90, and a top score of 83.

But this season, the Hampshire captain has scored 847 runs at 56.46 in England's first-class County Championship.

That includes innings of 74 and 147 against Nottinghamshire at Southampton last week.

England also have concerns over the balance of their attack, with pace-bowling all-rounders Stokes and Woakes not yet fully fit.

If either man is ruled out, it could lead to a return for 20-year-old Surrey left-arm swing bowler Curran, who was man-of-the-match in the first Test at Edgbaston.

England also have to decide whether to recall off-spinning all-rounder Ali, either as a replacement for, or an extra slow bowler in support of, leg-spinner Adil Rashid.

Whether Jonny Bairstow is fit to play after suffering a broken finger during India’s dominant win in the third Test, has still to be decided.

An innings of 219 and figures of 8-89 against Yorkshire have put Ali's name back in the frame. The four Test takes place on a ground where he took 6-67 against India during England's 266-run win in the corresponding Test four years ago.

That same Test also saw Alastair Cook end a run of low scores with an innings of 95. England would be delighted if its all-time leading Test run-scorer put another bad trot behind him in similar fashion this week.